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排序方式: 共有933条查询结果,搜索用时 15 毫秒
41.
Mitsugi Shimoda Rafik M Ghobrial Ian C Carmody Dean M Anselmo Douglas G Farmer Hasan Yersiz Pauline Chen Sherfield Dawson Francisco Durazo Steve Han Leonard I Goldstein Sammy Saab Jonathan Hiatt Ronald W Busuttil 《Liver transplantation》2004,10(12):1478-1486
The efficacy of orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC) associated with hepatitis C virus (HCV) is not well defined. This study examines the variables that may determine the outcome of OLT for HCC in HCV patients. From 1990 to 1999, 463 OLTs were performed for HCV cirrhosis. Of these patients, 67 with concurrent HCC were included in the study. Univariate and multivariate analyses considered the following variables: gender, pTNM stage, tumor size, number of nodules, vascular invasion, incidental tumors, adjuvant chemotherapy, preoperative chemoembolization, alpha-fetoprotein (AFP) tumor marker, lobar distribution, and histological grade. Overall OLT survival of HCV patients diagnosed with concomitant HCC was significantly lower when compared to patients who underwent OLT for HCV alone at 1, 3, and 5 years (75%, 71%, and 55% versus 84%, 76%, and 75%, respectively; P < 0.01). Overall survival of patients with stage I HCC was significantly better than patients with stage II, III, or IV (P < .05). Eleven of 67 patients developed tumor recurrence. Sites of recurrence included transplanted liver (5), lung (5), and bone (1). Twenty-four of 67 patients (36%) died during the follow-up time. Causes of deaths included recurrent HCC in 8 of 24 patients (12%) and recurrent HCV in 3 of 24 patients (4.5%), whereas 13 (19.5%) patients died from causes that were unrelated to HCV or HCC. Both univariate and multivariate analysis demonstrated that pTNM status (I versus II, III, and IV; P < .05) was a reliable prognostic indicator for patient survival. Presence of vascular invasion (P = .0001) and advanced pTNM staging (P = .038) increased risk of recurrence. Multivariate analysis showed that pretransplant chemoembolization and adjuvant chemotherapy reduced risk of death after OLT in HCC recipients. In conclusion, this study demonstrates the effectiveness of OLT for patients with HCC in a large cohort of chronic HCV patients. Advanced tumor stage, and particularly vascular invasion, are poor prognostic indicators for tumor recurrence. Early pTNM stage, adjuvant chemotherapy, and preoperative chemoembolization were associated with positive outcomes for patients who underwent OLT for concomitant HCV and HCC. 相似文献
42.
Background: The extrauterine migration of an intrauterine device (IUD) can be life threatening and require emergent surgical intervention and treatment. Migration is usually the result of IUD expulsion or uterine perforation. Objective: This case report describes a presentation of extrauterine migration of an IUD due to probable perforation. Case Report: This is a case report of an uncommon but potentially dangerous outcome of IUD placement and use. The potential migration of an IUD and resultant uterine perforation must be considered in the differential diagnosis of any woman using this type of contraception who presents with abdominal pain. This report is unique due to the subtle presentation of a potentially life-threatening diagnosis. Conclusion: This article presents the case, discusses the incidence, potential causes, predisposing factors, diagnostic modalities, and the course of treatment for this particular diagnosis. 相似文献
43.
OBJECTIVE--To determine the safety and immunogenicity of Haemophilus influenzae type b conjugate vaccine in children with sickle cell disease. RESEARCH DESIGN--Prospective, nonrandomized, nonblinded study. SETTING--Hospital-based, comprehensive sickle cell center. PATIENTS--Children with sickle cell disease aged 18 months to 18 years who were previously unvaccinated or had an inadequate or waning response to H influenzae type b polysaccharide vaccine. SELECTION PROCEDURES--Consecutive eligible patients. INTERVENTIONS--Vaccination and observation for adverse effects. Blood samples were taken before and 1 to 2 and 6 months after vaccination to measure anticapsular antibody levels. MEASUREMENTS AND RESULTS--Vaccination was well tolerated. One hundred percent and 96% of the 31 immunized children had postvaccination anticapsular antibody concentrations of greater than 0.15 and 1.0 mg/L, respectively. Six months after vaccination, 100% and 89% of children had these antibody concentrations. CONCLUSIONS--H influenzae type b conjugate vaccines are safe and highly immunogenic in children with sickle cell disease. It is likely that these vaccines will be protective against invasive H influenzae type b disease. 相似文献
44.
Effects of positive and negative pressure ventilation on cerebral blood volume of newborn infants 总被引:3,自引:0,他引:3
KS Palmer SA Spencer YABD Wickramasinghe T Wright DP Southall P Rolfe 《Acta paediatrica (Oslo, Norway : 1992)》1995,84(2):132-139
The effects of intermittent positive airway and continuous negative extrathoracic pressure ventilation on cerebral blood volume in preterm infants were studied using near infrared spectroscopy. In 12 infants continuous negative extrathoracic pressure caused a median decrease in cerebral blood volume of 0.14ml/100ml brain (95% confidence intervals (CI) 0.035–0.280) compared with no respiratory support. Oxygenated and deoxygenated haemoglobin also decreased, implying increased venous drainage as the main effect. In 17 infants intermittent positive pressure ventilation also caused a median reduction in cerebral blood volume of 0.06 ml/100 ml brain (95% CI 0.010–0.115) compared with endotracheal positive airway pressure. Deoxygenated haemoglobin increased by 0.07 ml/100 ml brain (95% CI 0.010–0.100) while oxygenated haemoglobin decreased by O.lOml/lOOml brain (95% CI 0.005–0.175). The increase in deoxygenated haemoglobin implies decreased venous drainage and the decrease in oxygenated haemoglobin implies that other factors may also be significant. Heart rate, blood pressure and oxygen saturation were monitored continuously and remained stable. 相似文献
45.
Effect of age and malnutrition on rotavirus infection in mice 总被引:1,自引:0,他引:1
M Riepenhoff-Talty E Offor K Klossner E Kowalski P J Carmody P L Ogra 《Pediatric research》1985,19(12):1250-1253
Litters of malnourished and normally nourished suckling mice of various ages were fed mouse rotavirus (10(5) ID50). Infection was monitored by immunofluorescent staining of isolated epithelial enterocytes 24, 28, and 72 h after virus ingestion; enzyme linked immunosorbent assay of daily fecal samples; and determining the severity of diarrhea by noting the color and consistency of the feces and the presence or absence of staining. In malnourished mice 5 to 9 days old, all the parameters of infection were significantly greater than in their normally nourished counterparts. However, in mice 10 to 14 days old the differences in extent and severity of infection in malnourished and normally nourished animals was not significant. After 15 days of age there were low levels of virus shedding and antigen-positive enterocytes in both malnourished and normally nourished animals, but there was no diarrhea in either group. Therefore it appears that nutritional manipulation, resulting in malnutrition, does not alter the state of refractoriness to symptomatic rotavirus infection in mice greater than 15 days old. 相似文献
46.
Genomic scale profiling of autoimmune inflammation in the central nervous system: the nervous response to inflammation 总被引:3,自引:0,他引:3
Carmody RJ Hilliard B Maguschak K Chodosh LA Chen YH 《Journal of neuroimmunology》2002,133(1-2):95-107
Using gene microarray technology, we found that inflammation in the central nervous system (CNS) not only induced the expression of many immune-related genes, but also significantly altered the gene expression profile of neural cells. Two unique groups of CNS genes were identified. The first group includes genes encoding ion channels, neural transmitters and growth factors. The second group includes genes that are important for nervous tissue regeneration. Additionally, a distinct pattern of gene expression was also identified in recovering animals. Thus, during autoimmune inflammation, the CNS actively responds to immune attacks by activating its own defense and repair genes. 相似文献
47.
48.
P Boutouyrie S Laurent B Laloux O Lidove JP Grunfeld DP Germain 《Acta paediatrica (Oslo, Norway : 1992)》2002,91(S439):62-66
Aim : The enzymatic defect in Fabry disease results in the slow systemic deposition of uncleaved glycosphingolipids in the lysosomes of vascular endothelium and smooth muscle cells, leading to ischaemic strokes, cardiomyopathy and renal failure. Whereas it is known that Fabry disease affects small blood vessels, little is known about its effects on peripheral large arteries. We therefore set out to compare parameters of arterial wall structure and function in a cohort of patients with Fabry disease and an age-matched control group. Methods : Large artery phenotype was non-invasively investigated in 21 hemizygous patients with Fabry disease and 24 age-matched male controls. Common carotid and radial artery diameter, intima-media thickness (IMT) and distensibility were determined with high-definition echotracking systems and aplanation tonometry. Results : Patients with Fabry disease had a significant twofold increase in radial artery IMT and distensibility, independent of body surface area, age and mean blood pressure. In both groups, older age at the time of examination was significantly associated with larger radial artery IMT. The relationship between age and radial IMT was 2.3-fold higher in patients with Fabry disease than in controls ( p > 0.01). Carotid IMT was mildly but significantly increased in patients with Fabry disease (+18%), whereas distensibility was unchanged.
Conclusion : This study presents evidence of a major increase in arterial wall thickness and distensibility, measurable at the site of a medium-sized artery, in a cohort of patients with classic Fabry disease. 相似文献
Conclusion : This study presents evidence of a major increase in arterial wall thickness and distensibility, measurable at the site of a medium-sized artery, in a cohort of patients with classic Fabry disease. 相似文献
49.
Abnormal spatial orientation and body postures in children with autism often interfere with visual abilities to attend tasks and social interactions. Twenty-four children diagnosed with autism from Kowloon, Hong Kong were assessed for spatial orientation and spatial management abilities. Positive changes in spatial orientation were evident when the children wore ambient prism lenses and included changes in posture from slanted to erect. Adjustments in spatial management were evident in improved ball catching ability, a task requiring visual tracking and eye-hand coordination. The findings suggest that alterations to the sensory systems may lead to behavioral change in some children. 相似文献
50.